Active NPI
Yvonne Fagan
- Pharmacist
- Rye, NY
National Provider Identifier
1548736200
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 057684
- Practice address
- 1121 Boston Post Rd
Rye, NY 10580-2912 - Phone
- (914) 921-4192
- NPI assigned
- Oct 22, 2018
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 057684 | NY | Primary |
Addresses
Primary practice location
1121 Boston Post Rd
Rye, NY 10580-2912
Mailing address
100 E Hartsdale Ave Apt Tiw
Hartsdale, NY 10530-3838
Phone (914) 815-5109
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 057684 | NY | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| CVS Albany LLC | Past | Accepting new patients | |
| CVS Albany LLC | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1540166400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1540166400000",
"number": "1548736200",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 E HARTSDALE AVE APT TIW",
"city": "HARTSDALE",
"state": "NY",
"postal_code": "105303838",
"telephone_number": "914-815-5109"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1121 BOSTON POST RD",
"city": "RYE",
"state": "NY",
"postal_code": "105802912",
"telephone_number": "914-921-4192"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FAGAN",
"first_name": "YVONNE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-10-22",
"last_updated": "2018-10-22",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Pharmacist",
"state": "NY",
"license": "057684",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rye, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.